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Renner J, Tesdorpf A, Freitag-Wolf S, et al. A retrospective study of conscious sedation versus general anaesthesia in patients scheduled for transfemoral aortic valve implantation: A single center experience. Health Sci Rep. 2018;2(1):e95doi: 10.1002/hsr2.95.
Renner, J., Tesdorpf, A., Freitag-Wolf, S., Francksen, H., Petzina, R., Lutter, G., Frey, N., & Frank, D. (2019). A retrospective study of conscious sedation versus general anaesthesia in patients scheduled for transfemoral aortic valve implantation: A single center experience. Health science reports, 2(1), e95. https://doi.org/10.1002/hsr2.95
Renner, Jochen, et al. "A retrospective study of conscious sedation versus general anaesthesia in patients scheduled for transfemoral aortic valve implantation: A single center experience." Health science reports vol. 2,1 (2019): e95. doi: https://doi.org/10.1002/hsr2.95
Renner J, Tesdorpf A, Freitag-Wolf S, Francksen H, Petzina R, Lutter G, Frey N, Frank D. A retrospective study of conscious sedation versus general anaesthesia in patients scheduled for transfemoral aortic valve implantation: A single center experience. Health Sci Rep. 2018 Nov 01;2(1):e95. doi: 10.1002/hsr2.95. eCollection 2019 Jan. PMID: 30697594; PMCID: PMC6346987.
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Health Sci Rep. 2018 Nov 01;2(1):e95. doi: 10.1002/hsr2.95. eCollection 2019 Jan.

A retrospective study of conscious sedation versus general anaesthesia in patients scheduled for transfemoral aortic valve implantation: A single center experience.

Health science reports

Jochen Renner, Anna Tesdorpf, Sandra Freitag-Wolf, Helga Francksen, Rainer Petzina, Georg Lutter, Norbert Frey, Derk Frank

Affiliations

  1. Department of Anaesthesiology and Intensive Care Medicine University Hospital Schleswig-Holstein Germany.
  2. Department of Trauma Surgery University Hospital Schleswig-Holstein Germany.
  3. Institute of Medical Informatics and Statistics Kiel University Germany.
  4. Department for Cardiovascular Surgery University Hospital Schleswig-Holstein Germany.
  5. Department of Cardiology and Angiology University Hospital Schleswig-Holstein Germany.

PMID: 30697594 PMCID: PMC6346987 DOI: 10.1002/hsr2.95

Abstract

OBJECTIVES: The current 2017 ESC/EACTS guidelines recommend transcatheter aortic valve implantations (TAVIs) as the therapy of choice for inoperable patients with severe symptomatic aortic stenosis. Most of the TAVIs worldwide are performed under general anaesthesia (GA). Although conscious sedation (CS) concepts are increasingly applied in Europe, it is still a matter of debate which concept is associated with highest amount of safety for this high-risk patient population. The aim of this single center, before-and-after study was to investigate feasibility and safety of CS compared with GA with respect to peri-procedural complications and 30-day mortality in patients scheduled for transfemoral TAVI (TF-TAVI).

METHODS: From March 2012 until September 2014, patients scheduled for the TF-TAVI procedure were included in a prospective, observational manner. From the 200 patients finally included, 107 procedures were performed under GA, using either an endotracheal tube or a laryngeal mask, and balanced anaesthesia. CS was performed in 93 patients using low-dose propofol and remifentanil.

RESULTS: Conversion to GA was needed 4 times due to procedural-related complications (4.3%), in one patient due to ongoing agitation (1.1%). The CS-group showed significantly shorter key time courses: anaesthesia time (105 [95-120] minutes vs 115 [105-140] minutes,

CONCLUSIONS: Our single-center data demonstrate that CS is a feasible and safe alternative, especially with respect to a higher degree of intra-procedural haemodynamic stability, and a reduced length of stay in the intensive care unit.

Keywords: TAVI; anaesthesia techniques; aortic stenosis; sedation

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